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Dec 29, 2018

Constant Leaks - Need Help with Drainable Pouches

This topic is about dealing with constant leaks from one-piece drainable pouches, which can be quite frustrating. The person experiencing this issue has been having daily leaks since late December, despite trying different brands. They are looking for solutions to improve the situation. Here are some helpful suggestions and insights:

- Consider using different products and configurations that have helped others reduce leaks:
1. Hollister 8661 one-piece wafer with Coloplast Brava Protective Seal and Brava Elastic "half-moon" Barrier Strips.
2. ConvaTec two-piece system with a moldable or cut-to-fit flange, which many users find lasts 6–8 days, and sometimes up to 10–17 days when combined with Brava Y or Elastic strips.
3. Coloplast SenSura Mio Click and SenSura Xpro Click, which have extended-wear adhesive.
4. Hollister Adapt Barrier Ring or Cera Ring, and Eakin Cohesive Seal 2, which is thicker and wider.
5. Use a standard ostomy belt or a DIY wide-elastic belt clipped to a two-piece flange for extra support, especially if you have a hernia.
6. "Active lifestyle" adhesive covers can provide additional security.

- Application techniques to improve adhesion:
1. Ensure the barrier fits snugly and evenly around the stoma to prevent gaps that cause leaks.
2. Warm the wafers before use with a hot shower, hair-dryer, heating pad, or hand pressure to activate the adhesive, as cold supplies can lose stickiness.
3. Shower to remove the old appliance, use non-moisturizing soap, adhesive-remover wipes, and skin-prep products, and make sure the skin is completely dry before reapplying.
4. Experiment with rolling barrier rings into a rope to build a custom dam around the stoma or keeping the ring whole and flattening it to see which method seals better for your skin.

- Accessory aids that might help:
1. Adhesive spray and barrier strips can significantly extend wear time.
2. KMEZVENT stick-on vents can eliminate the need to "burp" the pouch in public.
3. Bravo Y or Elastic strips, Hollister barrier strips, or tape "active lifestyle" covers can help prevent edge lift.

- Dietary and timing tips:
1. Avoid very large meals and heavy eating close to bedtime. Instead, try several small meals to maintain blood sugar while limiting nighttime output.
2. Change the appliance in the morning when the stoma is usually less active, such as before coffee or breakfast.

- Troubleshooting checklist:
1. Re-measure the stoma size, as shape changes can create gaps.
2. Try convex wafers if the stoma is flush or retracted.
3. Consult an enterostomal therapy (ET) nurse for hands-on fitting advice and access to manufacturer samples.

- Sampling and cost tips:
1. Contact Hollister, ConvaTec, and Coloplast directly for free samples of two-piece systems, convex wafers, Brava strips, and seals. Using fewer high-quality pouches may offset the higher unit cost.
See full discusison
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